Nov 2018: Investigating recent developments in the commissioning system
The Health and Social Care Act 2012 (HSCA 2012) introduced major changes into the commissioning system for the English NHS in 2013. Primary Care Trusts (PCTs) were replaced with Clinical Commissioning Groups, clinically-led statutory bodies responsible for the planning and commissioning of health care services for their local area. A new arms-length body, NHS England (NHSE), was established with responsibility for overseeing the work of CCGs. Commissioning responsibilities for local populations are now divided between CCGs, local authorities and NHSE. Since the HSCA 2012 took effect, there have been several
important policy developments, which affect the ‘new commissioning system’.
In 2014, The Five Year Forward View (5YFV) focussed on how organisations in the NHS need to cooperate with each other, and form new configurations known as ‘new care models’ (NCMs), the first wave of which have been designated ‘Vanguards’. There are also other organisational and service delivery changes being implemented across the country, designed to improve the integration of care. These changes take a range of forms including both horizontal and vertical integration.
In 2015, the relevant NHS national bodies issued a further policy document introducing the concept of local cooperative, place based planning, initially known as Sustainability and Transformation Plans and from March 2017 Sustainability and Transformation Partnerships (STPs). Despite these developments, there have been no relevant legislative changes, so the HSCA 2012 provisions concerning the respective roles of NHS commissioning organisations and the regulatory framework in respect of both procurement and provider competition remain in force. There is now a more complex local landscape of organisations all of which need to be involved in the planning of local services; and CCGs need to be able to find ways to engage with them effectively. This project investigated the initial stages of this process.
The questions addressed by the research were:
- How are CCG internal processes of decision making changing?
- What is the role of the individual CCG in the current commissioning landscape?
- How is accountability maintained by CCGs in the current commissioning landscape?
- How is competition and the current pricing regime relevant to CCGs’ commissioning decisions?
- How should commissioning develop?
- August 2021: National Evaluation of the Vanguard New Care Models Programme: Report of qualitative case studies
- June 2021: 10th National GP Worklife Survey
- June 2021: Exploration of the National Health Services Community Services Data Set Report
- March 2021: NHS Reorganisation
- Feb 2021: Integrated Care Systems interim report published
- Jan 2021: Stephen Peckham appointed to government select committee
- Dec 2020: Primary Care Networks: exploring primary care commissioning, contracting, and provision
- Nov 2020: Evidence on the impact of the Vanguard programme
- Nov 2020: Publication of ‘On Primary Care’
- Continuity of English primary care has worsened with GP expansions
- Mar 2018: PRUComm Annual Research Seminar [Event]
- Apr 2016: The future of commissioning [Event]
- Mar 2016: Examining the impact of the Health & Social Care Act: Examining developments in the English health system from 2013-2015 [Event]
- Feb 2013: Healthcare Commissioning Seminar: A summary
- Feb 2013 PRUComm research seminar on healthcare commissioning [Event]
- Jun 2011: How can evaluation contribute to health policy in England? [Event]